Monthly and Regional Global Cap Updates
The 2011-12 Final Budget set a cap on State (Department of Health) Medicaid spending of $15.3 billion in 2011-12 and $15.9 billion in 2012-13.
- The Medicaid cap is consistent with the Governor's goal to limit total Medicaid spending growth to no greater than the ten-year average rate for the long-term medical component of the Consumer Price Index (currently estimated at 4 percent).
- As part of the 2011-12 Budget agreement, $2.2 billion in State savings (growing to $3.3 billion in 2012-13) must be achieved so that spending is in line with the projected cap.
- The Department of Health (DOH) and the Division of Budget (DOB) will monitor and report program spending on a monthly basis to determine if spending growth is expected to exceed the forecasted Medicaid spending cap. Reports will be posted monthly on this website.
- If spending is projected to exceed the spending cap and Industry Led activities are not successful, DOH and DOB will develop and implement a plan of actions (known as the " Medicaid Savings Allocation Plans ") to bring spending in line with the cap.
- Medicaid Savings Allocation Plans could include actions such as modifying/suspending reimbursement methods (e.g., fees, premium levels, rates) and modifying program benefits. Once developed, such plans will be posted to the DOH Web site and written copies will be provided to the Legislature at least 30 days prior to implementation.
Monthly Spending Estimates
In 2011-12, the State's Medicaid program is currently estimated to cost taxpayers $53 billion in Federal, State and local government funds. The global cap on Medicaid spending pertains to the State share ($15.3 billion) of the portion subject to the Department of Health's oversight. The balance of State spending is largely related to mental hygiene agencies (Office of Mental Health, Office for Persons with Developmental Disabilities and the Office of Alcohol and Substance Abuse Services)
In order to accurately monitor the State's spending relative to the $15.3 billion cap, anticipated spending has been forecasted on a monthly basis for each category of service. The monthly forecast was developed to reflect:
- Actual spending patterns for State Fiscal Year (SFY) 2010-11 adjusted for one-time spending that is not expected to recur in SFY 2011-12;
- Anticipated increases in health care prices and estimated changes in service utilization in SFY 2011-12;
- The achievement of savings generated from 73 MRT actions over time; and
- Lower costs spread among the categories attributed to the $640 million in Health Care Industry savings and the $475 million Medicaid caseload reestimate.
- 2011-12 Monthly Global Cap Projections - April 10, 2012 (PDF, 270KB, 3pg.)
- 2011-12 Monthly Global Cap Projections - February 27, 2012 (PDF, 270KB, 3pg.)
- 2011-12 Monthly Global Cap Projections - December 29, 2011 (PDF, 270KB, 3pg.)
Monthly Report
- March 2012 Medicaid Global Cap Report (PDF, 775KB, 9pg.)
- Historical Updates
Regional Spending Estimates
- Economic Regions by County (PDF, 15.6KB, 1pg.)
- March 2012 Regional Global Cap Reports (PDF, 236KB, 12pg.)
- Historical Updates
